Precision Medicine Approach for Cardiometabolic Risk Factors in Therapeutic Apheresis

TY - JOUR

T1 - Precision Medicine Approach for Cardiometabolic Risk Factors in Therapeutic Apheresis

AU - Yin, X.

AU - Takov, K.

AU - Straube, R.

AU - Voit-Bak, K.

AU - Graessler, J.

AU - Julius, U.

AU - Tselmin, S.

AU - Rodionov, R.

AU - Barbir, M.

AU - Walls, M.

AU - Theofilatos, K.

AU - Mayr, M.

AU - Bornstein, S. R.

N1 - Funding Information: M.M. is a British Heart Foundation (BHF) ?hair Holder (?H/16/3/32406) with BHF programgrant support (RG/16/14/32397). The research was also supported by the National Institute for Health Research (NIHR) Biomedical Research ?entre based at Guy’s and St Thomas’ NHS Foundation Trust and King’s ?ollege London (the views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health). M.M. is also supported by the Leducq Foundation (18?VD02) and the VAS?age – Research ?enter on Vascular Ageing and Stroke (No. 868624). trans?ampus is funded by the Federal Ministry of Education and Research (BMBF) and the Freestate of Saxony under the Excellence Strategy of the Federal Government and the Länder. Publisher Copyright: © 2022 ASTM International. All rights reserved.

PY - 2022/4/12

Y1 - 2022/4/12

N2 - Lipoprotein apheresis (LA) is currently the most powerful intervention possible to reach a maximal reduction of lipids in patients with familial hypercholesterolemia and lipoprotein(a) hyperlipidemia. Although LA is an invasive method, it has few side effects and the best results in preventing further major cardiovascular events. It has been suggested that the highly significant reduction of cardiovascular complications in patients with severe lipid disorders achieved by LA is mediated not only by the potent reduction of lipid levels but also by the removal of other proinflammatory and proatherogenic factors. Here we performed a comprehensive proteomic analysis of patients on LA treatment using intra-individually a set of differently sized apheresis filters with the INUSpheresis system. This study revealed that proteomic analysis correlates well with routine clinical chemistry in these patients. The method is eminently suited to discover new biomarkers and risk factors for cardiovascular disease in these patients. Different filters achieve reduction and removal of proatherogenic proteins in different quantities. This includes not only apolipoproteins, C-reactive protein, fibrinogen, and plasminogen but also proteins like complement factor B (CFAB), protein AMBP, afamin, and the low affinity immunoglobulin gamma Fc region receptor III-A (FcγRIIIa) among others that have been described as atherosclerosis and metabolic vascular diseases promoting factors. We therefore conclude that future trials should be designed to develop an individualized therapy approach for patients on LA based on their metabolic and vascular risk profile. Furthermore, the power of such cascade filter treatment protocols may improve the prevention of cardiometabolic disease and its complications.

AB - Lipoprotein apheresis (LA) is currently the most powerful intervention possible to reach a maximal reduction of lipids in patients with familial hypercholesterolemia and lipoprotein(a) hyperlipidemia. Although LA is an invasive method, it has few side effects and the best results in preventing further major cardiovascular events. It has been suggested that the highly significant reduction of cardiovascular complications in patients with severe lipid disorders achieved by LA is mediated not only by the potent reduction of lipid levels but also by the removal of other proinflammatory and proatherogenic factors. Here we performed a comprehensive proteomic analysis of patients on LA treatment using intra-individually a set of differently sized apheresis filters with the INUSpheresis system. This study revealed that proteomic analysis correlates well with routine clinical chemistry in these patients. The method is eminently suited to discover new biomarkers and risk factors for cardiovascular disease in these patients. Different filters achieve reduction and removal of proatherogenic proteins in different quantities. This includes not only apolipoproteins, C-reactive protein, fibrinogen, and plasminogen but also proteins like complement factor B (CFAB), protein AMBP, afamin, and the low affinity immunoglobulin gamma Fc region receptor III-A (FcγRIIIa) among others that have been described as atherosclerosis and metabolic vascular diseases promoting factors. We therefore conclude that future trials should be designed to develop an individualized therapy approach for patients on LA based on their metabolic and vascular risk profile. Furthermore, the power of such cascade filter treatment protocols may improve the prevention of cardiometabolic disease and its complications.

UR - http://www.scopus.com/inward/record.url?scp=85128138270&partnerID=8YFLogxK

U2 - 10.1055/a-1776-7943

DO - 10.1055/a-1776-7943

M3 - Article

C2 - 35413745

AN - SCOPUS:85128138270

SN - 0018-5043

VL - 54

SP - 238

EP - 249

JO - Hormone and Metabolic Research

JF - Hormone and Metabolic Research

IS - 4

ER -